MEDICARE: ANTHONY J GAZZOLA JR DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1194689851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY J GAZZOLA JR DMD PC

Provider Business Mailing Address
First Line	:	6320 POST RD
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-1882
Country	:	US
Telephone Number	:	401-884-1525
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320 POST RD
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-1882
Country	:	US
Telephone Number	:	401-884-1525
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	ANTHONY GAZZOLA
Credential	:	DMD
Telephone Number	:	401-884-1525

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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